Ascending retrocecal appendicitis: clinical and computed tomographic findings
Sooah Kim1, Hyo K Lim, Ji Yeon Lee
1Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Journal of Computer Assisted Tomography
|September 7, 2006
Summary
Ascending retrocecal appendicitis often presents atypically. Computed tomography (CT) reveals a high rate of retroperitoneal inflammation and perforation in these cases.
Area of Science:
- Radiology
- Gastroenterology
- Surgical Pathology
Background:
- Appendicitis is a common surgical emergency.
- Ascending retrocecal appendicitis is a less common variant with potential for atypical presentation.
- Accurate diagnosis is crucial to prevent complications.
Purpose of the Study:
- To delineate the clinical presentation of ascending retrocecal appendicitis.
- To characterize the computed tomographic (CT) imaging features of this condition.
- To correlate CT findings with surgical outcomes.
Main Methods:
- Retrospective analysis of 1670 surgically confirmed appendicitis cases over 8 years.
- Inclusion of 33 patients with ascending retrocecal appendicitis who underwent contrast-enhanced abdominal CT.
- Analysis of clinical data and CT findings.
Main Results:
- Atypical abdominal pain presentations were common (right flank, upper abdomen).
- CT visualized inflamed appendices in most cases, with frequent retroperitoneal inflammation (Gerota and lateroconal fascia).
- Appendiceal perforation and abscess formation occurred in 49% of patients, predominantly in the retrocolic space.
Conclusions:
- Ascending retrocecal appendicitis frequently exhibits non-specific clinical symptoms.
- CT is valuable in identifying retroperitoneal inflammatory changes and perforation associated with this appendicitis variant.
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